Abstract P312: Sensitivity to Mental Illness and Life Enjoyment (smile) After Stroke

Abstract

Background: After experiencing a life changing stroke, survivors are often faced with a challenging journey back to wellness. This is particularly trying for those with depression and poor access to healthcare. In this study, we seek to assess the degree of depression and health-related quality of life (QOL) in first-time ischemic stroke patients compared to post-myocardial infarction (MI) patients in a county hospital system. Methods: Consecutive patients admitted for stroke and MI at a Los Angeles County Hospital were reviewed. Patients who meet the inclusion criteria and consented for participation were assessed for quality of life with EQ-5D-3L, depression with Patient Health Questionnaire 9 (PHQ-9) and knowledge of mental health resources. Stroke and MI severity were ranked and compared by hospital length of stay and day 90 mRS. Dichotomized variables were computed via t-test for parametric and Wilcoxon for nonparametric values. Multivariate analysis of non-parametric values was computed via Spearman correlation. Results: 61 stroke patients (mean age 59.7±13.4) and 52 MI patients (mean age 60.5±9.9) were included. Hospital length of stay did not significantly differ (mean 3.9 vs 2.5 days p=0.11). Day 90 mRS was significantly higher in the stroke group (mean 1.62 vs 0.96, p=0.004). PHQ-9 (mean 5.97 vs 6.85 p=0.13) and EQ-5D-3L (mean 7.4 vs 6.60 p=0.06) scores did not significantly differ. Among stroke patients (mean NIHSS 4.8 ±5.7), age correlated with day 90 mRS (r s =0.36 p<0.01). Initial NIHSS and stroke subtype did not correlate with either PHQ-9 or EQ-5D scores. Day 90 mRS correlated with PHQ-9 scores (r s =0.76 p<0.01, r s =0.65 p<0.01) and EQ-5D scores (r s =0.74 p<0.01, r s =0.78 p<0.01) in both groups. Only 6.5% of stroke and 15.1% of MI patients sought mental health resources. Conclusions: Stroke patients trended towards worse QOL scores, but lower depression scores than MI patients, though this did not reach statistical significance. Day 90 mRS correlated with worse QOL and depression scores in both groups. Despite high rates of depressive symptoms, very few patients had sought out mental health resources. This highlights the need to support mental health outreach, especially for vulnerable county patient populations.